- Tavel, JA
- Babiker, A
- Carey, C
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- Fox, L
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- Markowitz, N
- Munroe, D
- Paton, N
- Ruxrungtham, K
- Standridge, B
- Wentworth, D
- Wyman, N
- Aagaard, B
- Borup, L
- Grarup, J
- Jansson, PO
- Jensen, K
- Lundgren, J
- Mollerup, D
- Reilev, S
- Braimah, N
- Darbyshire, J
- Horton, J
- King, E
- Smith, N
- Van Hooff, F
- Cooper, DA
- Courtney-Rodgers, D
- Emery, S
- Finley, E
- Gordin, F
- Sánchez, A
- Thomas, D
- Bebchuk, J
- Bollenbeck, P
- Denning, E
- DuChene, AG
- Fosdick, L
- Harrison, M
- Krum, E
- Larson, G
- Neaton, JD
- Nelson, R
- Quan, K
- Quan, SFL
- Schultz, T
- Thompson, G
- Collins, S
- Haerry, DH
- Meulbroek, M
- Peavy, D
- Rappoport, C
- Schwarze, S
- Valdez, M
- Watson, J
- Belloso, WH
- Davey, R
- Duprez, D
- Gatell, JM
- Hoy, J
- Lifson, A
- Pederson, C
- Perez, G
- Price, R
- Prineas, R
- Rhame, F
- Sampson, JH
- Worley, J
- Modlin, JF
- Beral, V
- Chaisson, RE
- Fleming, TR
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- Kim, KM
- Murray, BE
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- Seligmann, M
- Weller, I
- Luzar, MA
- Martinez, A
- Costas, V
- et al.
Background: The Study of Aldesleukin with and without antiretroviral therapy (STALWART) evaluated whether intermittent interleukin-2 (IL-2) alone or with antiretroviral therapy (ART) around IL-2 cycles increased CD4+ counts compared to no therapy. Methodology: Participants not on continuous ART with ≥300 CD4+ cells/mm3 were randomized to: no treatment; IL-2 for 5 consecutive days every 8 weeks for 3 cycles; or the same IL-2 regimen with 10 days of ART administered around each IL-2 cycle. CD4 + counts, HIV RNA, and HIV progression events were collected monthly. Principal Findings: A total of 267 participants were randomized. At week 32, the mean CD4+ count was 134 cells greater in the IL-2 alone group (p<0.001), and 133 cells greater in the IL-2 plus ART group (p<0.001) compared to the no therapy group. Twelve participants in the IL-2 groups compared to 1 participant in the group assigned to no therapy experienced an opportunistic event or died (HR 5.84, CI: 0.59 to 43.57; p = 0.009). Conclusions: IL-2 alone or with peri-cycle HAART increases CD4+ counts but was associated with a greater number of opportunistic events or deaths compared to no therapy. These results call into question the immunoprotective significance of IL-2-induced CD4+ cells. Trial Registration: ClinicalTrials.gov NCT00110812.